Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies

Schneider, Ana Paula Helfer; Gaedke, Mari Ângela; Garcez, Anderson; Barcellos, Nêmora Tregnago; Paniz, Vera Maria Vieira

doi:10.1111/ijcp.13044

Cited by 22 publications

(10 citation statements)

References 48 publications

(167 reference statements)

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“…Bivariate analyses revealed that older adults with lower literacy skills and those who are members of racial/ethnic minority groups are likely to overcomplicate regimen dosing by taking medication a greater number of times per day than necessary, placing them at increased risk of medication errors, ADEs, and poor adherence. [17][18][19] While the seven-drug regimen provided to patients could be consolidated to be taken three times per day, patients on average dosed the regimen six times a day; only 1% of patients simplified the regimen to its optimal schedule. Like regimen dosing, regimen consolidation also declined significantly over time.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

Bailey

Opsasnick

Curtis

et al. 2019

J American Geriatrics Society

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OBJECTIVES We sought to investigate older patients' ability to correctly and efficiently dose multidrug regimens over nearly a decade and to explore factors predicting declines in medication self‐management. DESIGN Longitudinal cohort study funded by the National Institute on Aging. SETTING One academic internal medicine clinic and six community health centers. PARTICIPANTS Beginning in 2008, 900 English‐speaking adults, aged 55 to 74 years, were enrolled in the study, completing a baseline (T1) assessment. To date, 303 participants have completed the same assessment 9 years postbaseline (T4). MEASUREMENTS At T1, subjects were given a standardized, seven‐drug regimen and asked to demonstrate how they would take medicine over 24 hours. The number of dosing errors made and times per day that a participant would take medicine were recorded. Health literacy was measured via the Newest Vital Sign, and cognitive decline was measured by the Mini‐Mental State Examination. RESULTS Participants on average made 2.9 dosing errors (SD = 2.5 dosing errors; range = 0‐21 dosing errors) of 21 potential errors at T1 and 5.0 errors (SD = 2.1 errors; range = 1‐18 errors; P < .001) at T4. In a multivariate model, limited literacy (β = .69; 95% confidence interval [CI] = .18‐1.20; P = .01), meaningful cognitive decline (β = 1.72; 95% CI = .70‐2.74; P = .01), number of chronic conditions (β = .21; 95% CI = .07‐.34; P = .01), and number of baseline dosing errors (β = −.76; 95% CI = −.85 to −.67; P < .001) were significant, independent predictors of changes in dosing errors. Most patients overcomplicated their daily medication schedule; no sociodemographic characteristics were predictive of poor regimen organization in multivariate models. In a multivariate model, there were no significant predictors of changes in regimen consolidation over time, except regimen consolidation at T1. CONCLUSIONS Older patients frequently overcomplicated drug regimens and increasingly made more dosing errors over 9 years of follow‐up. Patients with limited literacy, cognitive decline, and multimorbidity were at greatest risk for errors. J Am Geriatr Soc 68:569–575, 2020

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Section: Discussionmentioning

confidence: 99%

Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

Bailey

Opsasnick

Curtis

et al. 2019

J American Geriatrics Society

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“…360,362À364 Importantly, only substantial risk reduction motivates patients for preventive drug treatment, which obviates the need for appropriate risk communication. 365,366 Depression is another important factor, and adequate treatment thereof improves adherence. 367,368 Mobile phone applications may improve adherence to both medication and behavioural changes.…”

Section: Optimizing Drug Adherencementioning

confidence: 99%

2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC)

Visseren¹,

Mach²,

Smulders³

et al. 2022

Revista Española de Cardiología (English Edition)

225

416

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“…In Vietnam, employees usually have their health insurance covered by their organization or by privileged healthcare preferential policies, which reduced the cost of drug treatment and increased the probability of medication adherence. The previous research by Schneider et al (2018) also showed that health insurance or drug treatment cost assistance programs were factors that had a positive impact on medication adherence in patients [21].…”

Section: Discussionmentioning

confidence: 88%

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic

et al. 2022

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The purpose of this study was to determine the medication adherence of outpatients with chronic diseases and the association between both patient attitudes and preventive practices regarding COVID-19 and their medication adherence. We performed a cross-sectional study in Vietnam. Medication adherence was determined using the translated and validated Vietnamese version of the General Medication Adherence Scale (GMAS). Patient attitudes and preventive practices regarding COVID-19 were measured using the 5K message of the Vietnam Ministry of Health (facemasks, disinfection, distance, no gatherings, health declarations). The associations between patient characteristics and medication adherence were determined by multivariable regression. The study included 1852 outpatients, and 57.6% of the patients adhered to their medications. Patients who recognized the pandemic’s obstruction of medical follow-ups (OR = 1.771; 95%CI = 1.461–2.147; p < 0.001), who applied ≥2 preventive methods (OR = 1.422; 95%CI = 1.173–1.725; p = 0.001), who were employed (OR = 1.677; 95%CI = 1.251–2.248; p = 0.001), who were living in urban areas (OR = 1.336; 95%CI = 1.090–1.637; p = 0.005,) who possessed higher education levels (OR = 1.313; 95%CI = 1.059–1.629; p = 0.013), or who had ≤2 comorbidities (OR = 1.293; 95%CI = 1.044–1.600; p = 0.019) were more likely to adhere to their medications. The adherence percentage for outpatients with chronic diseases was quite low during the pandemic. Patients who did not recognize the COVID-19 pandemic’s obstruction of medical follow-ups or who had poor preventive practices were less likely to adhere to medications. Healthcare providers should pay more attention to these groups to achieve desired treatment outcomes.

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Effect of characteristics of pharmacotherapy on non-adherence in chronic cardiovascular disease: A systematic review and meta-analysis of observational studies

Cited by 22 publications

References 48 publications

Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

Longitudinal Investigation of Older Adults' Ability to Self‐Manage Complex Drug Regimens

Medication Adherence of Vietnamese Outpatients with Chronic Diseases during the COVID-19 Pandemic

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